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Insight: How personalization can remedy the health management experience

Individuals now have more control over their health coverage selections and can often change their health plan.

Neil Huse, Clarity Solution Group

Mainstream consumers aren't engaged with health plans. They hear the news surrounding Healthcare Reform, but deep down, consumers feel only slightly more connected to their health plans than they do with their cable companies. The relationship is not personal; it's pragmatic and often considered nothing more than a necessity that exists in the background.

Health plan providers are constantly facing the reality that the day a member joins a plan may be the pinnacle of their positive consumer engagement. Recurring premiums are deducted from their wages, copayments may be higher than expected, a website may be difficult to navigate or they may spend 15 minutes on hold with a complex coverage question. Each of these individual experiences detracts from that initial upbeat feeling. Achieving a positive customer relationship can be further complicated when coverage selections weren't made by the individual in the first place. In these cases, health plans may be starting the consumer relationship from a deficit that continues to degrade over time.

With the introduction of Health Insurance Exchanges and individual markets, Plans can no longer afford to have a passive relationship with consumers. Individuals now have more control over their health coverage selections and can often change their health plan as easy as they can change mobile phone carriers.

Attracting the right population of consumers is an expensive and an inaccurate process. Retaining these consumers to reduce churn and engaging them intelligently so they are an active partners in their lifetime wellness is paramount to the continued viability of health plans. More importantly, engaging consumers in a meaningful relationship with an identifiable health coverage brand has a quantifiable hard dollar impact for health plans.

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Direct consumer engagement isn't a new domain. The advent of analytics, successful retailers, marketing partners, media brands and even consumer packaged goods companies have been mastering and innovating direct consumer engagement for decades; a concept that is only just now reaching healthcare. To paraphrase a frequently repeated management aphorism "To optimize operational efficiency, look within your industry; to drive innovation, look outside your industry."

Perhaps slightly dated, one might recall "Scoring Points: How Tesco is Winning Customer Loyalty", a groundbreaking work that documented the loyalty rewards program implemented by the British grocery chain in 1993. This book was an eye-opening introduction to data warehousing, the world of Big Data and its impacts long before the term was hyped. This was a real case study of individual engagement leveraged to maximum impact, now over two decades old.

Nearly every other industry can provide countless examples, strategies, techniques and tactics for engagement, yet health plans have been late to adopt them as a way of life. The health industry's maturity with consumers is now at a point of Economic Backwardness; desperately underserved, but poised for a profound leap forward in a digital landscape surrounded by examples of both visible successes and informative failures across a host of industries.

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Most consumers don't view themselves as part of a market segment, rather they see themselves as unique individuals with a personal life story. When consumers think of themselves as part of a group, most of the time they generally don't see themselves in the same group that Health Plans do when attempting to improve engagement.

What health plans must understand is consumers value a personalized experience. Two-thirds of consumers are more likely to trust and engage with brands that allow them to customize and share personalization and contact preferences. Over half of consumers feel more positive about a brand when messages are personalized and consumers are now placing a hard dollar value on how a brand personalizes the relationship.

Personalization is all about creating an enhanced consumer engagement. Consumers are constantly giving health plan providers a stream of subliminal messages that include a detailed story of their lives, how they want to be engaged and their responses to this engagement.

A successful personalization platform enables health plans to actively engage and retain the right consumers. It also allows them to educate consumers on preventative care, support convenient self-service options, encourage informed decision making and facilitate persuasive engagement and behavioral change.

To engage customers effectively, it is recommended that plan providers implement data management and analytic strategies and solutions that leverage the following:

  • Profile-based data that is integrated across all touch points and channels in order to provide a "segment of one."
  • Behavior-based data that is used based on interaction to drive personalization and achieve an integrated consumer experience.
  • Collaboration-based data that is integrated with relevant tools, relationships and touch points including experiential.
  • Adaptive data that leverages both explicit consumer feedback as well as implicit feedback from closed loop consumer responses.
  • Channel optimized, leveraging the right channel for the right message at the right time

Deep consumer analytics do not simply provide insight, they enable action and provide a platform for change. More importantly, they can deliver tangible quantifiable impacts including reducing preventable utilization, improving the adoption of personalized wellness recommendations, and achieving greater satisfaction, retention and positive engagement.

Each of these outcomes can be measured not only in the bottom line of total cost of care and profitability, but also in the years of sustainable relationships created on a personal level with consumers.

The benefits of enhanced personalized health management extend beyond the walls of the health plan, as well as they impact all the stakeholders engaged in a health management partnership. Members and Consumers benefit from improved wellness and enhanced satisfaction, employers who provide benefits can't improve productivity, motivate employees and impact the bottom line and providers can leverage the health plan partner as a data broker and participate in shared savings.

The capability to capture interaction and response data from all channels as a source of consumer feedback is the starting point for any personalization journey. Enrichment from third parties such as social and group-based interactions can also provide a snapshot of the consumer in the context of their relationships. Finally, data from experiential channels, for example a sponsored 5k race or sporting event, integrated with other components provides a view of the consumer in the context of their personal affinities and interests, aligned to how they see themselves.

Neil Huse is Practice Leader, Health and Life Sciences, at data and analytics consulting firm Clarity Solution Group.

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